> In 2016, they were spending $813/yr per person while the US was spending $9,403 per person. Despite this, life expectancy was/is about equal.
What Cuba does not have, making this possible:
- huge, huge administrative overhead. Both at the healthcare providers themselves and in the insurance sector. In addition, "rich" patients are not needed to subsidize care for patients who are uninsured/underinsured/cannot pay in full.
- obesity: 35% of US population is morbidly obese compared to 25% of Cuban population. Obesity is a massive driver of medical issues.
- "perverse incentives" where doctors are financially incentivized or, worse, forced by administration to e.g. operate on a patient when conventional therapy would be sufficient (this problem is also endemic in Germany, e.g. https://www.ndr.de/ratgeber/gesundheit/Kaputtes-Knie-Muessen...)
- CYA policies, e.g. when out of fear for malpractice lawsuits, unnecessary tests/labwork are done on the patient
- malpractice lawsuits/damage awards driving insurance premiums through the roof
- a tendency, especially in elderly people, to prolong their life at immense cost, even if it only brings them half a year in utter misery and pain (which is fine from an ethics point of view, intensive care at that level is just expensive as hell)
- hard drug addictions across wide swaths of the population. Smoking and drinking are bad enough but only the US has a huge problem with hardcore drug addicts. They cause cost in the system due to e.g. overdose treatments or contamination-caused complications
- large amounts of homeless/untreated mentally ill people, who often enough
- only come to a clinic when their health is so fucked that it's enormously expensive to nurse them back to health (aka on the brink of death)
- have their illness cause injury in other persons (e.g. due to fights)
- are directly affected by a lack of protection from the elements (e.g. freezing in winter, lack of shade in summer, lack of hygiene during the whole year)
- "abuse" medical resources to have a warm bed (which I'm not mad about, everyone deserves a warm bed, it's just a mis-allocation of resources contributing to the high costs for everyone else)